Individual provider Active NPI

Alexis Ventura

  • Psychiatric/Mental Health Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1609410463
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021065 Issued in CA
Practice address
8710 Monroe CT Ste 150
Rancho Cucamonga, CA 91730-4885
Phone
(909) 941-4870
Fax
(909) 941-4875
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95154959 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021065 CA Primary

Addresses

Primary practice location

8710 Monroe CT Ste 150
Rancho Cucamonga, CA 91730-4885

Mailing address

11210 4TH St Apt 2305
Rancho Cucamonga, CA 91730-6058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221103001342 CA Practitioner - Nurse Practitioner 7012384076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Psychiatric Medical Group IncGroup PAC ID 9436062312, 119 clinicians

Practice addresses (Care Compare)

8710 Monroe CT
Suite 150
Rancho Cucamonga, CA 91730-4885
Phone (909) 941-4870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc Nurse Practitioner CurrentSince Sep 28, 2022 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health Current Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatric/Mental Health CurrentSince Sep 28, 2022 Accepting new patients
Inland Psychiatric Medical Group Inc Psychiatric/Mental Health PastSince Jul 31, 2023 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

162 N Santa Fe St
Hemet, CA 92543
Phone (951) 506-9522

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

73700 Dinah Shore Dr
Ste 106
Palm Desert, CA 92211
Phone (760) 832-6352

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1609410463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11210 4TH ST APT 2305",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 MONROE CT STE 150",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304885",
            "telephone_number": "909-941-4870",
            "fax_number": "909-941-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95154959",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.